go back

Rhode Island rates for HCPCS 64495

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)

Facilitymedian $1,349 · 10th–90th $316–$3,8020%10%10th90th$1,349Professionalmedian $91 · 10th–90th $47–$2880%5%10%10th90th$91$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $3,981.07
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $85.11 / $190.55
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$138.04 / $338.84 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $389.05 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $83.18 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,230.27 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $91.20 / $165.96
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21